RESUMO
OBJECTIVE To investigate the influence of Huayu xiaozhong decoction （HXD） on inflammatory response in rats with deep vein thrombosis （DVT）. METHODS The male SD rats were divided into control group （CK group）， model group （Model group）， HXD low-dose group （HXD-L group， HXD 10.86 mg/kg）， HXD medium-dose group （HXD-M group， HXD 21.71 mg/kg）， HXD high-dose group （HXD-H group， HXD 32.57 mg/kg）， positive control group （LMWHS group， low molecular weight heparin sodium 600 IU/kg）， silent information regulator 2 （SIRT2） inhibitor group （AK-7 group， AK-7 20 mg/kg）， HXD-M+AK-7 group （HXD 21.71 mg/kg+AK-7 20 mg/kg）， with 12 rats in each group. Except for the CK group， the DVT rat was induced by the Reyers method in other groups； after modeling， administration groups were given relevant medicine intragastrically/intraperitoneally， once a day， for consecutive 2 weeks. Twenty-four hours after the last medication， the coagulation function indexes [activated partial thromboplastin time （APTT）， thrombin time （TT）， prothrombin time （PT）， fibrinogen （FIB）] and inflammatory indexes in serum and inferior vena cava tissue [interleukin-1β （IL-1β）， IL-6， tumor necrosis factor-α （TNF-α）] of rats were detected. The formation of thrombus was observed， and the wet and dry masses of the thrombus were weighed. The protein expressions of tissue factor （TF） and SIRT2 as well as the phosphorylation and acetylation levels of nuclear factor kappa B （NF-κB） p65 in inferior vena cava tissue were detected. RESULTS Compared with CK group， APTT， TT and PT of rats in Model group were shortened significantly（P＜0.05）； the content of FIB， the levels of IL-1β， IL-6 and TNF-α， wet weight and dry weight of venous thrombus， TF protein staining score， the phosphorylation and acetylation levels of NF-κB p65 protein increased significantly （P＜0.05）； the inferior vena cava was full of thrombus， and the protein expression of SIRT2 decreased （P＜0.05）. Compared with Model group， above indexes of HXD-L group， HXD-M group， HXD-H group and LMWHS group were improved， while the improvement effects of HXD-M group， HXD-H group and LMWHS group were significantly better than those of HXD-L group （P＜0.05）. The trends of the corresponding indicators in AK-7 group were opposite to the above （P＜0.05）； AK-7 attenuated the inhibitory effect of medium-dose HXD on the inflammatory response in model rats （P＜0.05）.CONCLUSIONS HXD may inhibit the inflammatory response of DVT rats by activating SIRT2/NF-κB signaling pathway.
RESUMO
Objective To investigate the clinical efficiency of Huayu Xiaozhong Decoction (HXD) on preventing peri-operative deep venous thrombosis (DVT) in lower limbs following artificial total hip replacement. Methods Ninety cases following artificial total hip replacement were randomized into blank control group, Rivaroxaban group and HXD group, 30 cases in each group, and were treated with brown sugar water, Rivaroxaban, HXD respectively. Before operation, and one, 3 and 14 days after operation, we monitored the changes of bleeding volume, DVT incidence, hemoglobin, prothrombin time ( PT) , activated partial thromboplastin time ( APTT) , international normalized ratio (INR), and D-dimer (DD) in the three groups. Results (1) Fifteen cases had DVT, with a total incidence rate of 16.67%. Of the 15 cases, 10 were from blank control group, 2 from Rivaroxaban group, and 3 from HXD group. ( 2) The amount of bleeding volume of Rivaroxaban group was larger than that of the blank control group and HXD group (P<0.05), but the bleeding was mild. (3) One, 3 and 14 days after operation, PT and APTT were shortened in blank control group (P<0.01 compared with those before operation). PT, APTT and INR were prolonged, and coagulation function was improved in Rivaroxaban group and HXD group, the differences being significant as compared with the blank control group ( P<0.05). HXD group had better effect on improving INR than Rivaroxaban group ( P<0.05). ( 4) In the three groups, hemoglobin level began to decrease on postoperative day one, arrived to the bottom on postoperative day 3 (P<0.05), and rose up near to the normal level on postoperative day 14; HXD group had higher hemoglobin level than blank control group and Rivaroxaban group on postoperative day 3 and 14 ( P<0.05). The 3 groups had higher plasma DD level than the normal level before the operation, arrived to the highest level on postoperative day one and 3 ( P<0.05) , and fell down near to the normal level on postoperative day 14. The inter-group comparison results showed that Rivaroxaban group and HXD group had lower DD level than the blank control group on postoperative day 3 and 14 ( P<0.05). Conclusion HXD is effective on preventing DVT in the peri-operation period through reducing bleeding, increasing hemoglobin level and improving postoperative anemia. The efficiency and safety of HXD are similar to Rivaroxaban.